Mertz Birgitte Goldschmidt, Duriaud Helle Molter, Kroman Niels, Andersen Kenneth Geving
a Breast Surgery Section , Rigshospitalet, Copenhagen University Hospital , Denmark.
b Section for Surgical Pathophysiology, Rigshospitalet , Copenhagen , Denmark.
Acta Oncol. 2017 May;56(5):724-729. doi: 10.1080/0284186X.2017.1295167. Epub 2017 Mar 2.
Sequelae such as pain, sensory disturbances and psychological distress are well known after treatment for invasive breast cancer (IBC). Patients treated for ductal carcinoma in situ (DCIS) receive a similar treatment as low-risk IBC. The aim of this cross-sectional study was to describe prevalence of postoperative pain, sensory disturbances, psychological distress and rehabilitation needs among Danish women with DCIS.
A total of 574 women treated for DCIS in Denmark in 2013 and 2014 were enrolled and 473 (82%) completed a detailed questionnaire on demographic factors, pain, sensory disturbances, psychological aspects and rehabilitation needs 1-3 years after surgery.
Median age was 60 years. A total of 33% of patients reported any pain and 12% reported moderate to severe pain in the area of surgery. Younger age (<50 years OR 4.7 (95% CI: 1.6-14.0, p = 0.006)), aged 50 to 65 years OR 2.8 (95% CI: 1.1-7.0, p = 0.02) and anxiety and depression (measured by HADS >15 OR of 3.1 (95% CI: 1.5-6.3, p = 0.003)) were significantly associated with moderate to severe pain. Approximately one-third of the patients reported sensory disturbances such as pins and needles (32%), numbness (37%) and painful itch (30%) and 94 women (20%) reported anxiety ≥8, 26 (6%) depression and 51 (11%) reported distress.
This cross-sectional study showed that women treated for DCIS suffered from pain, sensory disturbances and psychological impairment and had unmet rehabilitation needs. Further research is warranted, specifically addressing rehabilitation after diagnosis and treatment of DCIS.
侵袭性乳腺癌（IBC）治疗后，疼痛、感觉障碍和心理困扰等后遗症是众所周知的。原位导管癌（DCIS）患者接受的治疗与低风险IBC患者相似。这项横断面研究的目的是描述丹麦DCIS女性患者术后疼痛、感觉障碍、心理困扰及康复需求的患病率。
纳入2013年和2014年在丹麦接受DCIS治疗的574名女性，473名（82%）在术后1 - 3年完成了一份关于人口统计学因素、疼痛、感觉障碍、心理状况和康复需求的详细问卷。
中位年龄为60岁。共有33%的患者报告有任何疼痛，12%的患者报告手术区域有中度至重度疼痛。年龄较小（<50岁，比值比[OR]为4.7[95%置信区间（CI）：1.6 - 14.0，p = 0.006]）、50至65岁（OR为2.8[95% CI：1.1 - 7.0，p = 0.02]）以及焦虑和抑郁（通过医院焦虑抑郁量表[HADS]>15测量，OR为3.1[95% CI：1.5 - 6.3，p = 0.003]）与中度至重度疼痛显著相关。约三分之一的患者报告有感觉障碍，如刺痛（32%）、麻木（37%）和瘙痒疼痛（30%），94名女性（20%）报告焦虑≥8分，26名（6%）报告抑郁，51名（11%）报告有困扰。
这项横断面研究表明，接受DCIS治疗的女性存在疼痛、感觉障碍和心理损害，且康复需求未得到满足。有必要进行进一步研究，特别是针对DCIS诊断和治疗后的康复问题。
